Infertility
Infertility is the inability to produce offspring. A couple is considered "infertile" if, after a year of unprotected intercourse, no pregnancy occurs or a pregnancy does not culminate in a live birth. Approximately 15-20% of couples experience infertility--more than 80 million people world-wide. Initially, infertility was thought to occur only in women. Recognizing that men, too, can be infertile enhanced the possibility of a couple conceiving. The incidence rate of infertility in women and men is almost equal at approximately 35% and, in 15-30% of cases, both partners experience difficulties. Only five to 10% of infertile couples remain childless after appropriate treatment.
When the male sperm joins with the female egg, a new life begins. For many people, something interferes with this process and they cannot conceive. A thorough examination by a specialist is necessary to determine what that problem is and how it may be treated. Infertility in women can result from infection, irregularities in hormone production which interfere with ovulation (release of an egg from the ovary), or anatomical abnormalities (such as blocked or damaged fallopian tubes which prevents sperm from reaching the egg or the egg from reaching the uterus). Sometimes, the fertilized egg lodges in the fallopian tube resulting in an "ectopic" pregnancy. Endometriosis, an abnormality of the mucous membrane lining the uterus, prevents a fertilized egg from lodging and developing into a fetus. Certain antibodies produced by either the man or woman will act against the sperm, while poor general health, obesity, excessive stress, smoking, and alcohol consumption by either party are known to exacerbate infertility.
Testing women for infertility may include blood tests, ovulation tests, an endometrial biopsy, x-rays and ultrasound to reflect the shape and size of the uterus, and inspection of reproductive organs. Injection of dye into fallopian tubes followed by x-rays, or a laparoscopy (the insertion of a tiny lighted tube through the abdomen), help determine abnormalities or obstructions, and laparoscopic surgery with a surgical microscope and a laser beam often resolve these types of problems. Gonadotropins, drugs which induce ovulation, result in a conception rate between 15-50%, approximately 20% of which are multiple births (75% twins and 25% triplets or more). Miscarriage rate is approximately 25%.
Male infertility can be due to insufficient numbers of healthy sperm, inability to deliver sperm--as in the case of impotence or ejaculation disorders--damage to the testes by disease or injury, or failure of testes to descend into the scrotum. Treatments include a semen analysis (to determine volume and quality of seminal fluid); the number (sperm count), shape, size, and health of sperm; and the sperm's ability to penetrate the egg. Through a technique called sperm washing, healthy sperm can be isolated and separated from the semen then introduced into the woman's uterus through a simple procedure called artificial insemination. When the man proves completely infertile, artificial insemination using "donor" sperm is an option. Through a process called cryopreservation, donor sperm is frozen and kept in "sperm banks" for this purpose. The first successful artificial insemination with frozen sperm occurred in 1953. Since then, over 200,000 babies have been born through this method, with an estimated 30,000 babies born annually.
Many couples have children through a process called in vitro fertilization, (IVF) in which an egg removed from the woman is placed in a petri dish (or test tube) and mixed with the man's sperm. Once sperm and egg fuse, the fertilized ovum is inserted into the woman's uterus and, if it implants, pregnancy begins. The first birth using this method occurred in 1978. In cases where the woman's egg is unsuitable, "donor eggs" can be used.
This is the complete article, containing 598 words
(approx. 2 pages at 300 words per page).
